Early Ventricular Arrhythmias After LVAD Implantation Is the Strongest Predictor of 30-Day Post-Operative Mortality
Vincent Galand
(1, 2)
,
Erwan Flécher
(1)
,
Vincent Auffret
(3, 1)
,
Camille Pichard
(1)
,
Stéphane Boulé
(4)
,
André Vincentelli
(4)
,
Anne Rollin
(5)
,
Pierre Mondoly
(5)
,
Laurent Barandon
(6)
,
Mathieu Pernot
(7)
,
Michel Kindo
(8)
,
Thomas Cardi
(9)
,
Philippe Gaudard
(10, 11)
,
Philippe Rouvière
(12, 13, 11)
,
Thomas Sénage
(14)
,
Nicolas Jacob
(14)
,
Pascal Defaye
(15, 16)
,
Olivier Chavanon
(16)
,
Constance Verdonk
(17, 18)
,
Walid Ghodbane
(18)
,
Edeline Pelcé
(19)
,
Vlad Gariboldi
(19)
,
Matteo Pozzi
(20)
,
Jean-François Obadia
(21)
,
Arnaud Savouré
(22)
,
Frederic Anselme
(22)
,
Gerard Babatasi
(23)
,
Annette Belin
(23)
,
Fabien Garnier
(24)
,
Marie Bielefeld
(25)
,
David Hamon
(26)
,
Nicolas Lellouche
(27)
,
Bertrand Pierre
(28)
,
Thierry Bourguignon
(29, 30)
,
Romain Eschalier
(31)
,
Nicolas d'Ostrevy
(32, 31)
,
Marie-Cécile Bories
(33, 34)
,
Eloi Marijon
(35, 36)
,
Fabrice Vanhuyse
(37)
,
Hugues Blangy
(38)
,
Jean-Philippe Verhoye
(39, 1)
,
Christophe Leclercq
(3, 1)
,
Raphael Martins
(1)
1
LTSI -
Laboratoire Traitement du Signal et de l'Image
2 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
3 Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes]
4 Institut Coeur Poumon [CHU Lille]
5 Service Cardiologie [CHU Toulouse]
6 Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France
7 Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France
8 HUS - Les Hôpitaux Universitaires de Strasbourg
9 CHRU de Strasbourg - Centre Hospitalier Régional Universitaire de Strasbourg
10 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
11 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
12 Service de chirurgie thoracique et cardio-vasculaire
13 Department of Anesthesiology and Critical Care Medicine
14 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
15 Cardiac Stimulation and Rhythmology
16 Department of Cardiology and Cardiovascular Surgery, CHU Michallon, Grenoble, France
17 Hospital Bichat Paris
18 Department of Cardiology and Cardiac Surgery, Bichat-Hospital, Paris, France
19 TIMONE - Hôpital de la Timone [CHU - APHM]
20 Department of Cardiac Surgery, “Louis Pradel” Cardiologic Hospital, Lyon, France
21 Department of Cardiac Surgery, “Louis Pradel” Cardiologic Hospital, Lyon, France
22 Service de Cardiologie [CHU Rouen]
23 CHU Caen
24 Service de chirurgie cardio-vasculaire et thoracique (CHU Dijon)
25 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
26 Hôpital Henri Mondor
27 Service de cardiologie
28 Department of Cardiology and Cardiac Surgery, Tours University Hospital, Tours, France
29 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
30 Department of Cardiology and Cardiac Surgery, Tours University Hospital, Tours, France
31 Service Cardiologie Médicale et Médecine Vasculaire [CHU Clermont-Ferrand]
32 CHU Clermont-Ferrand
33 HEGP - Hôpital Européen Georges Pompidou [APHP]
34 Cardiology Department, European Georges Pompidou Hospital, Paris, France
35 Service de cardiologie pédiatrique [CHU Necker]
36 Cardiology Department, European Georges Pompidou Hospital, Paris, France
37 Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois
38 Service de Cardiologie [CHRU Nancy]
39 Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes]
2 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
3 Service de cardiologie et maladies vasculaires [Rennes] = Cardiac, Thoracic, and Vascular Surgery [Rennes]
4 Institut Coeur Poumon [CHU Lille]
5 Service Cardiologie [CHU Toulouse]
6 Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France
7 Hôpital Cardiologique du Haut-Lévêque, Université Bordeaux II, Bordeaux, France
8 HUS - Les Hôpitaux Universitaires de Strasbourg
9 CHRU de Strasbourg - Centre Hospitalier Régional Universitaire de Strasbourg
10 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
11 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
12 Service de chirurgie thoracique et cardio-vasculaire
13 Department of Anesthesiology and Critical Care Medicine
14 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
15 Cardiac Stimulation and Rhythmology
16 Department of Cardiology and Cardiovascular Surgery, CHU Michallon, Grenoble, France
17 Hospital Bichat Paris
18 Department of Cardiology and Cardiac Surgery, Bichat-Hospital, Paris, France
19 TIMONE - Hôpital de la Timone [CHU - APHM]
20 Department of Cardiac Surgery, “Louis Pradel” Cardiologic Hospital, Lyon, France
21 Department of Cardiac Surgery, “Louis Pradel” Cardiologic Hospital, Lyon, France
22 Service de Cardiologie [CHU Rouen]
23 CHU Caen
24 Service de chirurgie cardio-vasculaire et thoracique (CHU Dijon)
25 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
26 Hôpital Henri Mondor
27 Service de cardiologie
28 Department of Cardiology and Cardiac Surgery, Tours University Hospital, Tours, France
29 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
30 Department of Cardiology and Cardiac Surgery, Tours University Hospital, Tours, France
31 Service Cardiologie Médicale et Médecine Vasculaire [CHU Clermont-Ferrand]
32 CHU Clermont-Ferrand
33 HEGP - Hôpital Européen Georges Pompidou [APHP]
34 Cardiology Department, European Georges Pompidou Hospital, Paris, France
35 Service de cardiologie pédiatrique [CHU Necker]
36 Cardiology Department, European Georges Pompidou Hospital, Paris, France
37 Service de Chirurgie Cardiaque et Transplantations - Hôpital Brabois
38 Service de Cardiologie [CHRU Nancy]
39 Service de chirurgie thoracique cardiaque et vasculaire [Rennes] = Thoracic and Cardiovascular Surgery [Rennes]
Mathieu Pernot
- Fonction : Auteur
- PersonId : 1253110
- ORCID : 0000-0001-5882-8925
- IdRef : 089042522
Philippe Gaudard
- Fonction : Auteur
- PersonId : 19874
- IdHAL : philippe-gaudard
- ORCID : 0000-0003-1192-8704
- IdRef : 069716064
Thomas Sénage
- Fonction : Auteur
- PersonId : 1388573
- ORCID : 0000-0001-8203-0454
- IdRef : 157867684
Pascal Defaye
- Fonction : Auteur
- PersonId : 761246
- ORCID : 0000-0002-7183-4278
- IdRef : 133266575
Fabien Garnier
- Fonction : Auteur
- PersonId : 861871
- ORCID : 0000-0002-7749-952X
Romain Eschalier
- Fonction : Auteur
- PersonId : 782019
- ORCID : 0000-0003-3183-7084
- IdRef : 149395817
Nicolas d'Ostrevy
- Fonction : Auteur
- PersonId : 1345629
- IdHAL : ndostrevy
Eloi Marijon
- Fonction : Auteur
- PersonId : 767240
- ORCID : 0000-0001-7227-3428
- IdRef : 118900528
Christophe Leclercq
- Fonction : Auteur
- PersonId : 1247903
- ORCID : 0000-0002-4399-5568
Résumé
Objectives - This study aimed to evaluate incidence, clinical significance, and predictors of early ventricular arrhythmias (VAs) in left ventricular assist device (LVAD) recipients. Background - LVAD implantation is increasingly used in patients with end-stage heart failure. Early VAs may occur during the 30-day post-operative period, but many questions remain unanswered regarding their incidence and clinical impact. Methods - This observational study was conducted in 19 centers between 2006 and 2016. Early VAs were defined as sustained ventricular tachycardia and/or ventricular fibrillation occurring <30 days post-LVAD implantation and requiring appropriate implantable cardioverter-defibrillator therapy, external electrical shock, or medical therapy. Results - A total of 652 patients (median age: 59.8 years; left ventricular ejection fraction: 20.7 ± 7.4%; HeartMate 2: 72.8%; HeartWare: 19.5%; Jarvik 2000: 7.7%) were included in the analysis. Early VAs occurred in 162 patients (24.8%), most frequently during the first week after LVAD implantation. Multivariable analysis identified history of VAs prior to LVAD and any combined surgery with LVAD as 2 predictors of early VAs. The occurrence of early VAs with electrical storm was the strongest predictor of 30-day post-operative mortality, associated with a 7-fold increase of 30-day mortality. However, in patients discharged alive from hospital, occurrence of early VAs did not influence long-term survival. Conclusions - Early VAs are common after LVAD implantation and increase 30-day post-operative mortality, without affecting long-term survival. Further studies will be needed to analyze whether pre- or pre-operative ablation of VAs may improve post-operative outcomes. (Determination of Risk Factors of Ventricular Arrhythmias After Implantation of Continuous Flow Left Ventricular Assist Device With Continuous Flow Left Ventricular Assist Device [ASSIST-ICD]; NCT02873169).
| Origine | Fichiers produits par l'(les) auteur(s) |
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